Provider Demographics
NPI:1780704841
Name:EVERMAN, THOMAS LAWRENCE
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:LAWRENCE
Last Name:EVERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6434 FAIR OAKS BLVD # 343
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-4019
Mailing Address - Country:US
Mailing Address - Phone:916-342-4980
Mailing Address - Fax:
Practice Address - Street 1:2220 WATT AVE
Practice Address - Street 2:STE. B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0512
Practice Address - Country:US
Practice Address - Phone:916-485-6500
Practice Address - Fax:916-485-6814
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator